We are a Royal College of Veterinary Surgeons (RCVS) approved equine hospital.
Choke is a relatively common problem affecting horses where the oesophagus (also known as the gullet - the tube which food passes down from the mouth to the stomach) becomes blocked. It is not a blockage of the trachea (windpipe) unlike “choke” in humans. Blockages are typically caused by food such as un-soaked sugar beet pulp or pieces of carrot and apple but can be caused many different things.
Horses with choke usually have a frothy discharge from both nostrils - this may be white or green or food coloured (this is a mixture of saliva and food that has not passed down into the stomach). They often make repeated attempts to swallow and may stretch their necks out, or may appear to have “spasms” of the neck. Some horses with choke may cough (often coughing out saliva). Horses may appear anxious but should not show signs of colic such as rolling.
(KC / AG 2020)
Don’t panic! Most cases of choke will clear by themselves within a couple of hours without the need for any treatment. Take all food and water away from the horse (including edible bedding) and keep an eye on them. Gently massaging the left side of the neck over the jugular groove may help. The horse should look brighter when the choke clears and food and saliva will stop coming from the nostrils.
Most cases clear by themselves very quickly and you may not need to call the vet, but the vet should be called if:
Horses with choke are usually given specific medicines to help relax their oesophagus, which may include a sedative to keep them calm and encourage them to keep their heads low (which helps the saliva to drain from the nose and reduces the risk of food and saliva being inhaled into the lungs).
They may also be given be given some anti-inflammatories and pain relief (e.g. 'bute' or flunixin) as the oesophagus can become inflamed and sore.
In some cases horses are given a course of antibiotics to protect them from developing lung infections, such as pneumonia, which is a potential complication of choke.
In many cases, limited treatment is necessary because most choke cases will resolve spontaneously if left long enough (although this can take more than 24 hours in some cases). If the choke fails to clear with these conservative treatments, it maybe necessary to pass a stomach tube and attempt to gradually lavage (wash out) the obstruction; this is usually only done if the horse has had choke for a longer period of time.
In some cases it may be necessary for the horse to be admitted to the hospital for monitoring of hydration, along with endoscopy to assess and help flush out the obstruction.
Most cases resolve without complications and horses that have had choke should be bright and act normally the following day.
Less commonly, horses can develop pneumonia after having choke if they inhale some of the food and saliva into the lungs.
IT IS IMPORTANT TO MONITOR HORSES FOR ANY SIGNS OF COUGHING, HIGH TEMPERATURE OR DEPRESSION IN THE DAYS AFTER AN EPISODE OF CHOKE.
In rare cases the oesophagus can also form a permanent narrowing (stricture) after having choke – this may predispose the horse to further choke episodes.
Most cases of choke seem to be one off events caused by eating under-soaked feeds or perhaps particularly greedy horses eating too quickly.
Choke can be caused by other underlying problems such as teeth problems or swallowing problems. These should be investigated in horses that choke more than once.